Quality

About Inspections

Trinity Homecare is a registered Domiciliary Care Agency under the Care Standards Act 2000. We abide by the National Minimum Standards for Domiciliary Care Agencies based on the requirements of the Act. All care agencies are required to be registered and, to ensure they comply with the standards, they are inspected each year by The Commission for Social Care Inspection (CSCI).

Prior to the inspection visit, the agency is required to complete a detailed self assessment form that asks questions about compliance and the availability of policies and procedures and when they were last updated.

We are also asked to supply a list of clients with their contact details and at the same time to write to our clients and carers alerting them that they may be contacted by the inspector. The inspector then makes contact with a sample of clients and carers to find out about how the agency is performing and to check the level of satisfaction with outcomes. Clients and carers may also contact the inspector at any time if they wish to.

An unannounced visit is made to the agency when the Registered Manager and members of staff are questioned and documentation inspected. A detailed report is then produced, which is published on the CSCI website, which is available for anyone to download.

From April 2009, social care will be inspected by a new regulatory body, the Care Quality Commission, which will also be take over the functions of the Healthcare Commission and the Mental Health Act Commission.

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The Summary page of our last CSCI report is set out below.  “Excellent”

 

Commission for Social Care Inspection

Annual Service Review.    Name of Inspector: Jean Stuart.     Date 8th April, 2009

What did we do for the annual service review?

We look at all the information we have received, or asked for, since the last key inspection or annual service review.

This included:

• The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service.
• Surveys returned to us by people us by people using the service and from other people with an interest in the service.
• We sent survey forms to people who commission the service.
• Information we have about how the service has managed any complaints.
• What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement.
• The previous key inspection and results of any other visits that we have made to the service in the last 12 months.
• Relevant information from other organisations.
• What other people have told us about the service. We looked at all the information that we have received, or asked for, since the last key inspection or annual serve review.

What has this told us about the survey?

We received the annual quality assurance assessment (AQAA) within the agreed time. We got good information from the AQAA which explained how the agency meets the required standards. Detailed evidence showing how the service has improved was given.

Improvements include changing how information is given to people and staff, the presentatiobn has been simplified and "broken down into smaller paragraphs, in order to increase comprehension".  Bullet points are used as appropriate and "italic writing replaced with bold".  An additional note has been added to the service users' guide about issues people "need to consider when having a live-in carer".  The invoicing period has been changed from "weekly to four weekly so that clients do not have to keep on writing cheques".

The website has been redesigned and now breaks the information into smaller sections, and it introduces signposts to make it "user friendly".

Plans for the future will be based upon feedback forms received from "clients and carers".

We have not received any complaints about the service nor any safeguarding issues.

What are we going to do as a result of this annual service review?

We looked at the information in the AQAA and our judgement is that Trinity Homecare continues to provide excellent service and they know what further improvements they need to make. We are not going to change our inspection plan, and will do a key inspection by 12 April 2010.

However, we can inspect the service if we have concerns about the quality of the service or the safety of the people using the service. 

Commission for Social Care Inspection: www.csci.gov.uk

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Annual Quality Assurance Review for 2008

Under the Care Standards Act, all domiciliary care agencies are required to review annually their quality assurance process and make the results known to their clients. The review for the calendar year 2008 covers the following four Standards for Quality Assurance adopted by the agency:

Provide information about the service and the agency

 

When the Commission for Social Care Inspection (CSCI) carried out an inspection in February, 2005, the Inspector pointed out that we were required to communicate our Quality Assurance Review to our clients.  The last review, for calendar year 2007 was submitted to the Inspector on 31st January, 2008.  A copy of the review is also posted on our website and sent to all clients.   We continually review the information we send to prospective, as well as existing, clients.  We invariably have a few new clients who say there is too much information, but in our view live-in homecare is a complicated and difficult area, especially for people who have never had carers before.  We believe that all the information we give our clients is relevant and that not providing it would be a dereliction in our duty.

 

Understand clients’ needs so that suitable carers may be selected

 

In the past we have faced situations where new clients were not taken on because, in accordance with agency policy, they did not have a representative who would be able to make decisions on their behalf.  The Directors consider that this policy should continue, as this aspect is deemed vital for the smooth running of care for clients and to protect the interests of clients, carers and the agency. 

 

The Directors are satisfied that clients’ needs are understood sufficiently to recruit suitable carers, given the agency’s status as an “introduction” agency.  Extensive information about each client’s situation is maintained, and kept current, not only so as to understand clients’ needs, but also in order to select and brief  the next carer.

 

Recruit carers suited to the needs of clients

 

The agency tries very hard to place suitable carers, and in most cases we succeed.  In the few cases when we do not, we will replace the carer if requested.  It should be borne in mind though, that the more time we are given to select someone, and the better we know our client, the better able we are to choose the right person. 

 

Clients do have the opportunity to report on their carers as we send them a Client Satisfaction Form for each placement, and the responses to these give us some measure of how well we are selecting the carers.  The carers are rated according to the following criteria: Appearance, Attitude, Reliability, Conscientiousness, Initiative, Ability with Personal tasks, Ability with Household tasks. We ask clients to rate the carers 1 to 5 (5 being excellent) under these headings.  During the year we had 245 (269 in 2007) responses from clients.  Of those 109 or 44% (119 or 44% in 2007) gave their carers all 5s.  A further 37 or 15% (53 or 20% in 2007) got 5s in at least 5 out of 7 categories.  The rest were 4s (good) and some 3s (average).  6 carers (2.4%) had 2s in one or two categories.  Bearing in mind that the awarding of these scores are subjective and that some people just do not award 5s on principal, we are happy that we have been able to maintain our high standards.

 

Some comments received in letters from clients and their representatives in 2008 are set out below.

 

Respond to clients’ concerns and complaints

 

We are pleased that in 2008 our clients have continued to use the Client Satisfaction Forms sent to them to make comments about the agency, though because many clients submit a number of surveys in the course of the year as their carers change, the portion relating to the agency is not always completed. We ask clients to rate the agency 1 to 5 (5 being excellent) under the following headings:

In 2008, 192 forms out of 245 (187 forms out of 269 in 2007) were returned with the ratings for the agency filled in.  66% of them gave us the highest rating (5s) for all categories (2007, 58%). 8 clients included a score of 3 or below in their ratings: three for Acceptability of Carers and all eight for Clarity and Comprehensiveness of Documentation.  This was a little more than in 2007. The rest of the ratings included three or more 4s or left fields blank.  As most people use different criteria for awarding ratings we are happy that most of our clients are very pleased with the service that we provide. 

Some clients made written comments about the agency. A few compliments are:

“Excellent carer at very short notice”.

“We find the service Trinity Home care provides is efficient, friendly and professional”.

“Truly excellent, highly sensitive and appropriate provision of service”.

“Haven't needed to talk to the agency recently because it all settled down and we've got Carla & Sarah for several weeks which is a bliss and such a relief for my parents not to have to keep changing”.

“The agency have been great. Fionas tried to find the right people with necessary skills and juggle dates and trips. Wonderful”.

“I'm pleased to give you a 5 on all counts. I am particularly impressed by the thoroughness of your reports on proposed replacements for Caroline when she goes off for a few days. Moreover, the quality of the replacements appears to have been more than acceptable”.

“Only to add, once again, our sincere thanks for all your considerable help in the care of Mrs B”.

“The agency has produced a very suitable carer with minimum fuss”.

“An excellent service delivered by a very conscientious team”.

“You are very helpful as an organisation, it must be quite difficult, dealing with people's needs”.

“Being our first experience of working with homecare for my mother all the staff at Trinity have helped enormously and made it as easy and uncomplicated as possible”.

We do occasionally have comments from clients that they thought that our fees were too expensive and didn't understand why they should continue to pay the agency fee on a continuing basis. We don't deny that the fees are expensive, but we have our costs to cover and our fees are in the middle of our peer group of competitors. Generally in the recruitment field it is usual for fees to represent 20% to 30% of the appointee's annual salary. In the case of homecare, where clients' situations can change very suddenly it would clearly be unfair to make such an up-front charge, especially when the carers only stay for two to three months. Effectively, the cost of recruitment is charged over the time periods the benefit is received, though our fee structure is based on a one-off placement fee, which is invoiced in instalments.

The Directors are satisfied that clients concerns are addressed in a timely manner. We are very pleased that the inspector from the Commission for Social Care Inspection, who last inspected us on 11th June, 2008 recognised this in her report.